Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 23, 2025
Date Accepted: May 9, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Clinical and cost-effectiveness of telehealth-supported home oxygen therapy on adherence, hospital readmission, and health-related quality of life in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis of randomized controlled trials
ABSTRACT
Background:
Tele-monitoring and management play a crucial role in optimizing home oxygen therapy for patients with chronic obstructive pulmonary disease. As the use of tele-monitoring to improve adherence, reduce hospital readmissions, and enhance health-related quality of life grows, existing evidence remains inconsistent and warrants further examination.
Objective:
This study aims to evaluate the clinical and cost-effectiveness of telehealth-supported home oxygen therapy on adherence, hospital readmission, and health-related quality of life in patients with chronic obstructive pulmonary disease.
Methods:
A comprehensive search was conducted across six databases (PubMed, Cochrane Central, Embase, Web of Science, PsycINFO, and CINAHL) through October 1, 2024. Meta-analysis and heterogeneity testing were performed using R software, and standardized mean differences with 95% confidence intervals were calculated to assess intervention effects.
Results:
Seven studies, involving 1,230 patients, were included in the analysis. Telehealth-supported home oxygen therapy significantly reduced hospital readmissions (SMD: −0.40, 95% CI: [−0.60, −0.21]) and improved health-related quality of life (SMD: 0.44, 95% CI: [0.15, 0.72]). However, it did not have a significant impact on therapy adherence (SMD: 0.19, 95% CI: [−0.76, 1.14]). Sensitivity analysis confirmed the stability of the results for hospital readmission. Additionally, three economic studies indicated that while telehealth interventions may involve higher initial costs, they are likely to lead to long-term savings by reducing hospital admissions.
Conclusions:
Telehealth-supported home oxygen therapy significantly reduces hospital admissions and improves health-related quality of life among patients with chronic obstructive pulmonary disease. However, it does not significantly enhance adherence. Tailored interventions, designed to address patient demographics, combined with supportive policies, could further improve outcomes. Future studies should incorporate economic evaluations to guide policy decisions regarding the implementation of telehealth-supported home oxygen therapy. Clinical Trial: PROSPERO CRD42024598539
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.